Jones v. Chidester - 531 Pa. 31, 610 A.2d 964 (1992)

Rule:

A school of thought is a "considerable number of reputable and respected physicians." A school of thought must be adopted not only by "reputable and respected physicians" in order to insure quality but also by a "considerable number" of medical practitioners for the purpose of meeting general acceptance even if it does not rise to the level of a majority.

Facts:

Appellant Billy Jones underwent orthopedic surgery on his leg performed by Dr. John H. Chidester. In order to create a bloodless field for the surgery, the surgeon employed a tourniquet which was elevated and released at various intervals. Because of subsequent problems with the leg, appellant was referred to a neurosurgeon who determined that appellant had suffered nerve injury to the leg. Appellant instituted a suit, alleging that his nerve injury was the result of Dr. Chidester’s use of the tourniquet. During trial, Dr. Chidester’s experts told the court and the jury that the doctor’s technique was acceptable medically in the particular case. On the other hand, appellant’s experts insisted that it constituted unacceptable practice. The district judge instructed the jury regarding the two schools of doctrine in medical malpractice. The district judge instructed that a jury of layperson should not be put in a position of choosing one respected body of medical opinion over another when each has a reasonable following among the members of the medical community. Thus, according to the district judge, under the two schools of thought doctrine, a physician in the position of Dr. Chidester will not be held liable to a plaintiff merely for exercising his judgment in applying the course of treatment supported by a reputable and respected body of medical experts, even if another body of medical experts' opinion would favor a different course of treatment. The jury returned a verdict in favor of Dr. Chidester. Appellant filed a post-trial motion alleging that he was entitled to a new trial because the court’s instruction to the jury on the two schools of thought doctrine was reversible error. Appellant argued that under Pennsylvania law, the test for the doctrine was “considerable number” rather than “reputable and respected” as the court had charged the jury. Appellant challenged the order of the Superior Court which affirmed the order of the trial court denying their motion for a new trial in his medical malpractice action against Dr. Chidester.

Issue:

Did the trial court’s instruction to the jury on the two schools of thought doctrine constitute a reversible error, entitling appellant to a new trial?

Answer:

Yes.

Conclusion:

On appeal, the court reviewed the progression of the "two schools of thought" doctrine through its several decisions. The court reviewed decisions of various other states. The doctrine provided a complete defense to medical malpractice. It was insufficient to show that there existed a "small minority" of physicians who agreed with a questioned practice. Therefore, the "reputable and respected by reasonable medical experts" test was improper. To create a "school of thought," there had to be a considerable number of physicians, recognized and respected in their field, who ascribed to a treatment. The court stated the correct law as: Where competent medical authority was divided, a physician will not be held responsible if in the exercise of his judgment he followed a course of treatment advocated by a considerable number of recognized and respected professionals in his given area of expertise. There was no numerical certainty on what was a "considerable number." The court reversed and remanded for a new trial.